BMJ  2007;334:1078 (26 May), doi:10.1136/bmj.39223.354942.DB

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US comes last in international comparison of health systems

Janice Hopkins Tanne

New York

The first 150 words of the full text of this article appear below.

Three times in a row the US health system has come last in the US Commonwealth Fund's survey of health systems in six industrialised nations.

The United Kingdom was ranked first overall, scoring highest on quality, efficiency, and equity. In terms of "healthy lives"—measured by numbers of preventable deaths and life expectancy—Australia ranked highest.

The US and the UK had poor scores on indicators of healthy lives, the report said. Both countries had high mortality (in 1998) from treatable conditions. Mortality was 25% to 50% higher in the US and the UK than in Canada and Australia.

The US ranked last on the five dimensions of a high performance health system: quality, access, patients' safety, efficiency, equity, and healthy lives. The analysis drew results data from three international surveys of patients and primary care doctors.

The US performed best of all the countries in preventive care, "an area that has . . . [Full text of this article]


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